Journal of Medical Case Reports · 6 authors, 2 centres
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A 42-year-old woman with total blindness not explained by physiological processes was initially misdiagnosed with factitious disorder, resulting in disability income suspension and family conflict. Psychiatric evaluation reclassified her condition as a dissociative neurological symptom disorder with visual disturbance (ICD-11 6B60.0), linked to childhood trauma and psychological distress.
A 42-year-old woman was placed on medical leave at age 32 for persistent atypical facial neuralgia and subsequently developed total blindness without identifiable organic cause. She was initially diagnosed with factitious disorder, leading to disability income suspension and family conflict. Ophthalmological examination found no evidence of diffuse retinopathy, maculopathy, or optic neuropathy, and moderate vitamin B12 deficiency was ruled out as a cause since blindness was already present years earlier. Psychiatric evaluation linked her symptoms to childhood trauma, insecure attachment, and significant unconscious psychic conflicts, concluding diagnoses of pain disorders related to psychological factors and dissociative neurological symptom disorder with visual disturbance (ICD-11 6B60.0). The case underscores that misdiagnosis between factitious and somatoform/dissociative disorders carries severe socio-economic repercussions, and differentiating these conditions is essential from both treatment and insurance medicine perspectives.
